Transcription of SELF ATTESTATION FORM
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SELF ATTESTATION FORM
SELF ATTESTATION FORM INSTRUCTIONS This template allows for applicants to self-attest their eligibility for the STAY DC program based on any ONE or MORE of the following required criteria: Rental Obligation ( , proof of residence at an eligible rental unit in the absence of a lease/rental/sublease agreement) Financial Impact ( , unemployment, reduction in income, significantly increased expenses, or other financial hardship) Housing Impact ( , risk of housing instability or homelessness) Income qualification ( , total household income at or below 80% AMI) Carefully read each section and complete ONLY the applicable criteria sections for which you are unable to provide the required supporting documentation or a written ATTESTATION from an applicable third-party and thus needing to self-attest.
Household Income Attestation IF you cannot provide the requiredocumentation d ando NO d T qualify for any ofhe t above programs at thisme, ti please use this form to document your income. [IF you have the required documentation and plan to providet as i part of your application, you can skip to the signature page.]
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